Nutrition, metabolism, and cardiovascular diseases : NMCD · 2025
The association of obesity and other metabolic disorders with COVID-19 mortality: a cross-sectional analysis of death certificates from Veneto (Italy) and Bavaria (Germany).
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Buschner Andrea, Fedeli Ugo, Zoppini Giacomo
Аннотация
BACKGROUND AND AIM: The study investigates mortality related to obesity and other metabolic disorders during the pandemic, comparing findings from two large European regions.
METHODS AND RESULTS: All death certificates of residents aged 45-84 years in Veneto (Italy) and Bavaria (Germany) were extracted from January 2020 to December 2022. The proportion of deaths reporting obesity, diabetes, and hypertension was computed both for all-cause and for COVID-19 deaths. The prevalence of mention of metabolic disorders was compared between deaths attributed to COVID-19 and all other deaths by means of Odds Ratios (OR) with 95 % Confidence Intervals (CI) estimated by conditional logistic regression stratified by age, sex, and year of death. Overall 81,125 deaths in Veneto (8.5 % attributed to COVID-19) and 253,862 in Bavaria (5.9 % from COVID-19) were investigated. At least one metabolic disorder was mentioned in 35.8 % of all COVID-19 deaths in Veneto and 26.7 % in Bavaria. Obesity-related deaths sharply peaked in each epidemic wave in both regions, with a less marked pattern for hypertensive diseases and diabetes. The association with COVID-19 increased with the number of reported metabolic disorders, was stronger among younger ages and in Veneto. Estimated OR for COVID-19 death among decedents aged 45-64 years with two/three vs. no metabolic disorder were 4.24 (CI 3.33-5.40) in Veneto and 2.14 (1.83-2.51) in Bavaria.
CONCLUSION: The strong association between deaths from COVID-19 and number of metabolic disorders among younger ages highlights the need for prioritizing preventive interventions for obesity and associated metabolic conditions.
METHODS AND RESULTS: All death certificates of residents aged 45-84 years in Veneto (Italy) and Bavaria (Germany) were extracted from January 2020 to December 2022. The proportion of deaths reporting obesity, diabetes, and hypertension was computed both for all-cause and for COVID-19 deaths. The prevalence of mention of metabolic disorders was compared between deaths attributed to COVID-19 and all other deaths by means of Odds Ratios (OR) with 95 % Confidence Intervals (CI) estimated by conditional logistic regression stratified by age, sex, and year of death. Overall 81,125 deaths in Veneto (8.5 % attributed to COVID-19) and 253,862 in Bavaria (5.9 % from COVID-19) were investigated. At least one metabolic disorder was mentioned in 35.8 % of all COVID-19 deaths in Veneto and 26.7 % in Bavaria. Obesity-related deaths sharply peaked in each epidemic wave in both regions, with a less marked pattern for hypertensive diseases and diabetes. The association with COVID-19 increased with the number of reported metabolic disorders, was stronger among younger ages and in Veneto. Estimated OR for COVID-19 death among decedents aged 45-64 years with two/three vs. no metabolic disorder were 4.24 (CI 3.33-5.40) in Veneto and 2.14 (1.83-2.51) in Bavaria.
CONCLUSION: The strong association between deaths from COVID-19 and number of metabolic disorders among younger ages highlights the need for prioritizing preventive interventions for obesity and associated metabolic conditions.